A 72-year old gentleman is seen in the surgical ICU who is day 2 post-op from a mitral valve repair, CABG x 3, maze procedure and resection of the left atrial appendage (for correction of severe mitral regurgitation and AF). He still has A+V epicardial pacing wires in situ with AAI pacing set at 90 bpm but the nursing staff are concerned that his rhythm has become irregular. He also complains of some anterior sternal discomfort that is worse with deep breathing and coughing. He is otherwise stable with BP 130/70, MAP 95, clear chest, normal mental status and good urine output.
His ECG is shown below. What inference can be made from the ECG? What could be the probable diagnosis for this case? *This case is from the Docplexus Editorial Team and is meant for educative purpose only.
